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General NPI Number Information
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NPI Number | 1154486421
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Entity Type | Organization
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Legal Business Name | STONESTOWN PEDIATRICS
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 595 BUCKINGHAM WAY #355
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1909
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Country | US
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Telephone | 415-566-2727
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Fax | 415-566-0081
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Provider Business Mailing Address
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Address Line | 595 BUCKINGHAM WAY #355
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1909
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Country | US
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Telephone | 415-566-2727
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Fax | 415-566-0081
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. MITCHELL C SOLLOD
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Credential | M.D.
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Telephone | 415-566-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | C27394
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | FNP30374
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License Number State | CA
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